Prevalence and factors associated with HIV& HBV Co-infection among pregnant women attending antenatal care clinic at Kawempe National Referral Hospital

Abstract

Background: Approximately 10 % of all HIV infected patients worldwide are estimated to have chronic HBV co-infection. However, wide regional variations are observed with co-infection prevalence rates estimated to be 5–10 % in areas such as North America, Europe and Australia compared to higher prevalence rates of 20–30 % in areas such as Sub-Saharan Africa and Asia. HIV positive pregnant women are three times more likely to test positive for HBV DNA and twice as likely to test positive for HBeAg. Both higher HBV viral load and HBeAg expression are associated with an increased risk of an HIV-infected pregnant woman's transmission of HBV to her child. The prevalence of HIV&HBV co-infection among pregnant women attending ANC at Kawempe National Referral Hospital was unknown. Moreover, a better understanding of factors associated with HBV-HIV co-infection would be beneficial to any treatment and prevention program aimed to curb the spread of both infections. Therefore, the aim of this study was to determine the prevalence and factors associated with HIV&HBV co-infection among pregnant women attending ANC at Kawempe National Referral Hospital. Methods: A Cross-sectional study involving 1400 pregnant women was conducted at the ANC clinic of Kawempe National Referral Hospital. All participants gave written informed consent. Data was collected using interviewer administered questionnaires and collection of blood samples from the participants for HIV and HBsAg testing. The Data was entered Using Epi data version 4.2 and analyzed with STATA version 14.1. Results: The prevalence of HIV&HBV co-infection was 5.4%. Participants who had the following factors were more likely to have HIV&HBV co-infection; history of delivery with the help of TBA (AOR = 4.80, 95%CI1.764-13.081), having history of STIs (AOR = 5.26, 95%CI 1.754-15.770), having HBV positive household member (AOR = 24.43, 95%CI 7.476-79.843), having history of body fluid splashes from HBV positive patient (AOR =22.57, 95%CI 7.135-71.373). The following factors had inestimably high COR and thus showed a strong association with HIV&HBV co-infection; having a positive RPR status, history of live sex multiple sexual partners and having pierced ears. Conclusions and recommendations: The prevalence of HIV&HBV co-infection was of intermediate endemicity, 5.4%. Delivery with a TBA, STIs, HBV positive household member, body fluid splashes from HBV positive patient, positive RPR status, multiple sexual partners and pierced ears were associated with dual infection. We recommend testing all pregnant women for HIV and HBV during ANC prioritizing those with the above risk factors.